Autopsy Research Articles

Study Of Unknown Dead Bodies Brought For Post Mortem In Tertiary Hospital

Background: Medico legal autopsies are conducted in India in two circumstances: cases where a person has died because of unnatural circumstances and where the body of the deceased is unidentified. The present study relates to the latter of the two aforementioned circumstances, i.e. where the dead body is not identified. Methodology: In present descriptive prospective study the size and magnitude of problems regarding unidentified bodies. Also the profile of unidentified dead bodies such as age, cause of death, post-mortem interval, manner of death, seasonal trends, area (urban or rural), place from where the body was recovered was studied Results: Total 1919 bodies were brought to us of which 169 cases were selected. The mean age of the patients was 44.82±14.83 years with male predominance. Most of the cases were identified on the basis of the clothes belonging and 16.57% bodies were brought from the rural areas. Majority of the unidentified bodies were found in the autumn season (28.99 %). Maximum unidentified dead bodies were discovered at religious places (n= 64, 37.87 %). In the present study, most deaths were natural, n=114 (67.46 %) and the majority of autopsies were performed between 4 and 6 days (n= 73, 43.20%) Regarding the cause of death according to police records in the present study, it was determined that there were the most cases of illness/ diseased condition (n=55). Conclusion: Unknown/unclaimed should be presented for autopsy forthwith without any delay so that decomposition and other artifacts do not set in and obscure the findings of the postmortem examination

First case of mucormycosis (Rhizopus nigricans) in a cat

AbstractRhizopus nigricans is a species of fungus responsible for opportunistic mucormycotic infections in immunosuppressed subjects. Sparse reports of mucormycosis exist in veterinary literature; however, central nervous system involvement, resulting from R. nigricans infection has not been discussed. This report describes an 8‐year‐old, male, neutered Ragdoll with fungal meningoencephalitis secondary to intracranial colonisation of R. nigricans. Clinical signs were indicative of multifocal disease affecting the forebrain/cerebellum, and were characterised by abnormal mentation, compulsive circling, menace deficits and hypermetria. Fungal encephalitis was suspected based on magnetic resonance imaging findings and brain histology, with the diagnosis reached following postmortem examination, subsequent culture and polymerase chain reaction sequencing. This is the first report of cerebral mucormycosis in a feline patient that discusses the clinical, diagnostic and histopathological test findings.

Clinical, Radiological and Pathological Features of a Large American Cohort of Spinocerebellar Ataxia (SCA27B).

Spinocerebellar ataxia 27B due to GAA repeat expansions in the fibroblast growth factor 14 (FGF14) gene has recently been recognized as a common cause of late-onset hereditary cerebellar ataxia. Here we present the first report of this disease in the US population, characterizing its clinical manifestations, disease progression, pathological abnormalities, and response to 4-aminopyridine in a cohort of 102 patients bearing GAA repeat expansions. We compiled a series of patients with SCA27B, recruited from 5 academic centers across the United States. Clinical manifestations and patient demographics were collected retrospectively from clinical records in an unblinded approach using a standardized form. Post-mortem analysis was done on 4 brains of patients with genetically confirmed SCA27B. In our cohort of 102 patients with SCA27B, we found that SCA27B was a late-onset (57 ± 12.5 years) slowly progressive ataxia with an episodic component in 51% of patients. Balance and gait impairment were almost always present at disease onset. The principal finding on post-mortem examination of 4 brain specimens was loss of Purkinje neurons that was most severe in the vermis most particularly in the anterior vermis. Similar to European populations, a high percent of patients 21/28 (75%) reported a positive treatment response with 4-aminopyridine. Our study further estimates prevalence and further expands the clinical, imaging and pathological features of SCA27B, while looking at treatment response, disease progression, and survival in patients with this disease. Testing for SCA27B should be considered in all undiagnosed ataxia patients, especially those with episodic onset. ANN NEUROL 2024;96:1092-1103.

Post-mortem distribution of MDPHP in a fatal intoxication case.

The synthetic cathinone (SC) 3,4-methylenedioxy-α-pyrrolidinohexanophenone (MDPHP), is structurally correlated to the 3,4-methylenedioxypyrovalerone (MDPV). In recent years, the number of intoxication cases has increased even if little is known about the pharmacokinetics properties. The post-mortem (PM) distribution of MDPHP remains largely unexplored. In these reports, MDPHP levels were quantified in blood, gastric content and urine. This study aimed to describe the MDPHP PM distribution in several specimens, i.e. central and peripheral blood (CB and PB), right and left vitreous humor (rVH and lVH), gastric content (GCo), urine (U) and hair. The samples were collected from a cocaine-addicted 30-year-old man with a PM interval estimated in 3-4 h. Autopsy examination revealed unspecific findings, i.e. cerebral and pulmonary edema. No injection marks were observed. Toxicological analyses were performed using a multi-analytical approach: headspace gas chromatography for blood alcohol content (BAC); gas chromatography-mass spectrometry (GC-MS) for the main drugs of abuse; liquid chromatography-tandem mass spectrometry (LC-MS/MS) for benzodiazepines and new psychoactive substances (NPS). BAC was negative (0.02 g/L). MDPHP concentrations were: 1,639.99 ng/mL, CB; 1,601.90 ng/mL, PB; 12,954.13 ng/mL, U; 3,028.54 ng/mL, GCo; 1,846.45 ng/mL, rVH; 2,568.01 ng/mL, lVH; 152.38 (0.0-1.5 cm) and 451.33 (1.5-3.0 cm) ng/mg, hair. Moreover, hair segments were also positive for 3,4-dimethylmethcathinone (DMMC < limit of quantification: 0.01 ng/mg), α-PHP (0.59 ng/mg, 0.0-1.5 cm; 3.07 ng/mg, 1.5-3.0 cm), cocaine (6.58 ng/mg, 0.0-1.5 cm; 22.82 ng/mg, 1.5-3.0 cm), and benzoylecgonine (1.13 ng/mg, 0.0-1.5 cm; 4.30 ng/mg, 1.5-3.0 cm). MDPHP concentrations were significantly higher than those reported in the literature for fatal cases. For these reasons, the cause of death was probably the consumption of a lethal amount of MDPHP. Because CB and PB were similar, PM redistribution was not relevant.

Intentional harm in marine mammals stranded dead in the Adriatic Sea, Croatia, 1990-2023.

Intentional harm to marine mammals refers to deliberate human actions that cause injury, suffering, or death, and it is illegal in many countries. These actions often result from direct human attacks and are motivated by various reasons, with retaliation by fishermen being the most common. Such attacks cause severe tissue damage, frequently leading to the debilitation or death of the targeted animal. In this report, we document 13 cases of intentionally harmed marine mammals: 12 bottlenose dolphins Tursiops truncatus and 1 Mediterranean monk seal Monachus monachus found in the Croatian part of the Adriatic Sea between 1990 and 2023. Our analysis includes the life history data of the attacked specimens, post-mortem findings, and the weaponry involved. Among 311 post-mortem examinations conducted, 4.2% revealed intentional harm. Adult male bottlenose dolphins were most frequently targeted (46.2%), with a majority (53.8%) succumbing immediately due to exsanguination. Shotgun pellets, bullets, and underwater speargun spearheads were recovered from their carcasses. The attacks occurred with no discernible seasonal pattern; however, 61.5% of the cases were recorded from Istria County. Our findings underscore the inadequacy of current surveillance and enforcement in protecting marine mammals from deliberate harm. We advocate for the implementation of educational initiatives targeting relevant groups, intensive sea patrols, and routine inspection of weapons with high penalties for illegal possession and misuse, all reinforced by media campaigns to combat this malicious human behaviour.

Cardiac Echinococcosis

Abstract Hydatid disease has a worldwide distribution and can involve any body organ, though the liver and lung are most involved. Cardiac hydatid cysts are a rare occurrence and can cause fatal complications. Here, we discuss one such case of a 60-year-old female who presented with cough and expectoration with difficulty in breathing. On investigations, chest X-ray, and two-dimensional echocardiography, the presence of a cystic mass was noted in bilateral lung fields extending into the left atrium, and hence, the diagnosis of hydatid cyst was made. During her course of illness, the patient developed acute respiratory distress syndrome which was managed intensively, but the patient eventually succumbed to her illness. Postmortem examination confirmed the existence of a ruptured hydatid cyst in the left atrium. Early detection and treatment could have led to a better outcome of disease. Thus this case report highlights the importance of considering Hydatid disease as a differential for patients presenting with unexplained cardio-pulmonary symptoms especially in agriculture dependent areas of hydatid endemic nations.

Operando visualisation of lithium plating by ultrasound imaging of battery cells.

While developing battery cells, the achievement of fast-charging capability is heavily dependent on avoiding metallic plating on the anode surface (i.e., lithium plating in lithium-ion cells). However, this objective hinges on the effectiveness of plating detection. Currently, measurement techniques are either inadequate in providing spatial, temporal, or causal information, incur high costs when employing, e.g., neutron imaging, or are lengthy due to destructive post-mortem examinations that additionally lack operando data. In this work, we demonstrate an ultrasound imaging method for operando visualization of the interior of a multi-layer pouch battery cell. Here we show that this method can non-invasively visualize the formation and stripping of lithium plating during cycling. Extensive reference electrode studies and ex-situ analysis verify the effectiveness of our method for plating detection. Ultimately, this work enables researchers and industry to significantly accelerate the development of new cell technologies and their optimized utilization.

Pseudomonas aeruginosa sepsis in a neonate Franciscana dolphin (Pontoporia blainvillei): clinical approach and laboratory findings

A neonate (4,2 kg and 71 cm total body length) female Franciscana dolphin, Pontoporia blainvillei, was found stranded alive on a beach in Santa Catarina, Southern Brazil, with respiratory signs (dyspnea, crackles during thoracic auscultation and changes in buoyancy) suggestive of pneumonia. Hand-rearing and rehabilitation efforts were unsuccessful, and the neonate died three days after it was rescued. Postmortem investigation was conducted using diagnostic imaging techniques, such as endoscopy and computed tomography. A complete necropsy and histopathology were performed, revealing bronchopneumonia as well as neutrophilic and discrete otitis media. A pure Pseudomonas aeruginosa culture was obtained from the blowhole, bronchoalveolar lavage, and blood using the API NE System. Our results indicate the cause of death to be related to bacterial sepsis. Further understanding of the main causes of death of Franciscana dolphin calves is warranted for conserving this threatened and understudied species. Keywords: bacterial septicemia, cetacean, otitis, pneumonia, Pseudomonas aeruginosa, rehabilitation, stranding event

Proteomic and Lipidomic Plasma Evaluations Reveal Biomarkers for Domoic Acid Toxicosis in California Sea Lions.

Domoic acid is a neurotoxin secreted by the marine diatom genus Pseudo-nitzschia during toxic algal bloom events. California sea lions (Zalophus californianus) are exposed to domoic acid through the ingestion of fish that feed on toxic diatoms, resulting in domoic acid toxicosis (DAT), which can vary from mild to fatal. Sea lions with mild disease can be treated if toxicosis is detected early after exposure. Therefore, rapid diagnosis of DAT is essential but also challenging. In this work, we performed multiomics analyses, specifically proteomic and lipidomic, on blood samples from 31 California sea lions. Fourteen sea lions were diagnosed with DAT based on clinical signs and post-mortem histological examination of brain tissue, and 17 had no evidence of DAT. Proteomic analyses revealed 31 statistically significant proteins in the DAT individuals compared to the non-DAT individuals (adjusted p < 0.05). Of these proteins, 19 were decreased in the DAT group of which three were apolipoproteins that are known to transport lipids in the blood, prompting lipidomic analyses. In the lipidomic analyses, 331 lipid species were detected with high confidence and multidimensional separations, and 29 were found to be statistically significant (adjusted p < 0.05 and log2(FC) < -1 or >1) in the DAT versus non-DAT comparison. Of these, 28 were lower in the DAT individuals, while only 1 was higher. Furthermore, 15 of the 28 lower concentration lipids were triglycerides, illustrating their putative connection with the perturbed apolipoproteins and potential use in rapid DAT diagnoses.

Novel goose parvovirus in naturally infected ducks suffering from locomotor disorders: molecular detection, histopathological examination, immunohistochemical signals, and full genome sequencing

ABSTRACT In this study, we investigated the pathological effects of novel goose parvovirus (NGPV) infection on the skeletal muscle, brain, and intestine of naturally affected ducks suffering from locomotor dysfunction as a new approach for a deeper understanding of this clinical form. For this purpose, a total of 97 diseased ducks, representing 24 flocks of different duck breeds (14–75 days old), were clinically examined. In total, 72 tissue pools of intestine, brain, and skeletal muscle samples were submitted for molecular identification. Typical clinical signs among the examined ducks suggested parvovirus infection. Regarding postmortem examination, all examined ducks showed muscle emaciation (100%) either accompanied by congestion (34%) or paleness (66%). Slight congestion, either in the brain (82.5%) or intestine (75.25%), was predominantly detected. Based on molecular identification, the intestine had the highest percentage of positive detection (91.7%), followed by the skeletal muscle (70.8%), and the brain (20.8%). The main histopathological alterations were myofibre atrophy and degeneration, marked enteritis accompanied by lymphocytic infiltration in the lamina propria and submucosa, while the affected brains showed vasculitis, diffuse gliosis, and Purkinje cell degeneration in the cerebellum. Next-generation sequencing further confirmed the presence of a variant strain of goose parvovirus (vGPV) that is globally known as NGPV and closely related to Chinese NGPV isolates. Using immunohistochemistry, the NGPV antigen was positively detected in the muscle fibres, enterocytes, and Purkinje cells in the cerebellum. These findings provided proof of the involvement of virus replication in the locomotor disorders linked to NGPV infection in ducks.

To prevent sudden death in m.3243A>G carriers, comprehensive neurologic, cardiac, and pulmological examinations are required.

The interesting study has limitations that put the results and their interpretation into perspective. m.3243A>G carriers should undergo prospective testing for multisystem disease to avoid missing subclinical multisystem involvement. m.3243A>G carriers with hypertrophic cardiomyopathy require long-term electrocardiogram recordings to determine whether implantable cardioverter defibrillator implantation is necessary or not. To assess the outcome of m.3243A>G carriers, knowledge of heteroplasmy rates and mtDNA copy numbers is required. It is tempting to assign pathogenicity when any pathogenic variant is seen with genotype-phenotype correlation. However, double hits are possible and if genetic information is to be used to screen or risk-stratify other family members, the standard of care would be to ensure that post-mortem genetic autopsy is performed for a panel of causative genes, and that an autopsy is done to exclude other causes of death, if possible.

Key Qualities, Manipulations, Negligence and Ethical Challenges in Postmortem Examinations

The credibility of forensic investigations and the legal system as a whole are seriously threatened by manipulation, negligence, and unethical behaviour during postmortem examinations. Breaking ethical rules can lead to inaccurate conclusions about the cause and manner of death, which compromises the validity of important forensic evidence used in court. Findings may be biased by outside influences from law enforcement, families, or well-known people, impeding the pursuit of justice. Furthermore, incorrect interpretations might arise from procedural errors and missed facts, which can be especially detrimental when forensic evidence is crucial. Falsifying documents is one example of an unethical behaviour that erodes public trust in medico-legal institutions. These challenges are made worse by a lack of funding, poor training, and possible conflicts of interest, all of which compromise the impartiality and thoroughness of postmortem investigations. To tackle these challenges and enhance accountability and integrity in the field of forensic pathology, it is crucial to undertake comprehensive reforms. This includes establishing stricter regulatory frameworks, upgrading infrastructure, boosting human resources, improving videographic documentation, providing enhanced ethical and specialized training, and ensuring more effective resource allocation.

Identification of Mycoplasma Species in Cattle Associated with Bovine Respiratory Disease Mortality.

Approximately 30 distinct Mycoplasma species have been isolated from cattle, but only a few are pathogenic and can cause serious respiratory diseases. Consequently, this study aimed to identify Mycoplasma spp. infections in cattle with bovine respiratory disease (BRD), considering factors such as animal demographics, concurrent infections with other pathogens, post-mortem clinical findings and histological examinations, and seasonality. A total of 326 samples were collected from 322 cattle that had died from BRD in Northwestern Italy. A total of 54 animals (16.8%) tested positive for Mycoplasma spp., and Mycoplasma bovis (n = 22, 40.7%) and Mycoplasma dispar (n = 13, 24.1%) were the most frequently detected species among the examined cattle. Among positive cattle, those aged five months or younger were approximately five times more likely to be infected by Mycoplasma dispar than by Mycoplasma bovis compared to those older than five months (proportional incidence ratio: 5.1, 95% CI 1.2-21.2). The main bacterial pathogens identified in cattle exhibiting co-infection was Pasteurella multocida, whereas the main viral pathogens were BRSV and BoHV-1. Histopathological investigations predominantly revealed catarrhal bronchopneumonia or purulent catarrhal bronchopneumonia among the examined cattle. Finally, Mycoplasma hyopharyngis, a species isolated from the pharyngeal and nasal cavities of pigs so far, was detected for the first time in the pneumonic lung of a bovine infected with BRD. Further investigations are necessary to thoroughly characterize its host range and pathogenic potential.

The mouse gingiva and HIF-1α, a key gene of hypoxic environment, as tools for post-mortem time estimation.

The post-mortem interval (PMI) is the time elapsed between the death of an individual and its forensic examination. It is a crucial information for judicial authorities, but current techniques still cannot establish a precise time interval. Novel approaches are therefore required. Recently, gingival tissue has emerged as interesting for forensic analysis thanks to the protection offered by lips to this tissue, limiting the influence of environmental factors. It is also easily accessible, and its sampling is minimally invasive even in the presence of rigor mortis. Moreover, the expression of HIF-1α, a master mediator of the hypoxic environment, has been described in gingival samples at different post-mortem (PM) times. We have hypothesized that the time-dependent post-mortem expression of HIF-1α could serve as a biomarker to more accurately predict the PMI. Our analyses were performed in an animal model, the mouse, where environment can be precisely controlled. Therewith, gingival tissue morphology was evaluated through histochemical staining and HIF-1α expression was analyzed by qPCR, western blots and immunofluorescence at different post-mortem times (0h to 100h). Our results showed (a) a global post-mortem stability of gingival tissue (b) a rapid increase in HIF-1α mRNA expression in the short post-mortem times followed by a slow decrease in transcript expression until 100h PM (c) an expression of the HIF- 1α protein and its degradation products, that follows the mRNA pattern (d) the presence of HIF-1α protein in the epithelial and connective layers of the tissue, with signal accumulation in both gingival strata until at least 32h post-mortem. This pilot study thus validated the mouse and the gingival tissue as models for post-mortem analyses, as well as for studying the fate of proteins such as HIF-1α. Transferring these approaches to human subjects may provide a more accurate estimate of PMI.

Findings of synthetic cathinones in post-mortem toxicology

Synthetic cathinones (SCs) are a group of new psychoactive substances with amphetamine-like effects but generally higher potency. The aim of this study was to assess the incidence and significance of SCs in post-mortem (PM) investigations in Finland, focusing on the three most prevalent substances: α-PVP, α-PHP, and α-PiHP. All PM cases positive for SCs during 2018–2023 were investigated with respect to cause and manner of death, PM blood and urine concentrations, and concomitant use of other drugs of abuse. There were 136 findings of α-PVP, α-PHP, or α-PiHP in 118 death cases, in which the median age at death was 35 years and 82 % were males. Concomitant opioids, stimulants, or sedatives were found in 69–92 % of cases, and cannabis in 39–47 %. In two cases (1.7 %), SCs were the only findings of abused drugs. Thirty-four fatal poisonings (29 %) were identified in which at least one of the three SCs was implicated in the cause of death. The median (range) femoral blood concentrations of α-PVP, α-PHP, and α-PiHP in these poisoning cases were 0.18 (0.03–2.6) mg/L, 0.16 (0.02–0.58) mg/L, and 0.14 (0.03–2.1) mg/L, respectively. α-PVP, α-PHP and α-PiHP were found in 4.0 % of all drug abuse cases and in 2.7 % of all fatal poisonings related to drug abuse, while for amphetamine/methamphetamine, these figures were 44 % and 21 %, respectively. Despite their lower prevalence in PM cases, SCs appear to have similar abuse liability and similar drug use patterns to amphetamine.

Examination protocol of dismembered bodies in railway track: A suggestive review in the Indian railways backdrop

Railway-related fatalities often involve dismembered bodies, which pose unique forensic challenges. There is the need for standardized examination procedures, especially in India, where about 30% of bodies in railway track are unidentified. Distinguishing accidental trauma from criminal dismemberment requires sophisticated forensic expertise. The protocol emphasizes a systematic approach, including scene investigation, body part documentation, and post-mortem examination. Key aspects include proper handling of multiple body parts, assessment of postmortem intervals, and precise injury documentation. Ancillary investigations, such as radiological examination including PMCT and Micro CT, histological sampling, object or tool mark analysis and entomological analysis are to be used to meet the secondary objectives of autopsy. The review aims to standardize investigation procedures, improve forensic reporting accuracy, and enhance the quality of railway-related death investigations.

HPB O04 - Human Splenic Ex-Vivo Perfusion Model: A Platform for Translational Basic Science Research

Abstract Background The function of the spleen has always been shrouded in mystery and since the Renaissance leading figures have attempted to understand its function. Vesalius questioned Galen and Marcello Malpighi (1628-1694) gave the first accurate description of the histology and the physiology. The spleen still poses unique challenges as invasive approaches may produce intraperitoneal bleeding, differences between human and animal spleens complicates comparative studies, and post-mortem examinations reveal only late-stage disease manifestations and functional studies are impossible. This study describes a human splenic ex-vivo perfusion model for translational research, using microbiological studies as markers of splenic physiological function. Method Patients with left-sided pancreatic cancers scheduled for distal pancreatic and splenic resection were identified from the Hepato-Pancreatic and Biliary MDT at the University Hospitals of Leicester NHS Trust. Patients were informed, consented, and the surgical approach remained standard, with splenic artery ligation deferred until specimen extraction. The artery was cannulated, and residual blood clots were cleared with Custodiol® HTK solution. The perfusion technique employs an extracorporeal circuit incorporateing anoxygenator and a heated water chamber maintaining a 37°C perfusate. The perfused spleen was infected with Streptococcus Pneumoniae strains, with regular biopsies and perfusate gas analysis performed. Results Since February 2023, nine spleens have been successfully perfused, with an average weight of 169.5 grams, cold ischemic time of 116 minutes, and warm ischemic time of 12.2 minutes. Pressure was maintained at 80 mmHg and hourly perfusate gas analysis demonstrated a mean pH of 7.1 and a gradual increase in lactate. Histopathological examination revealed clear distinctions between the lymphoid tissue and splenic red pulp, with intact central arterioles and healthy cell morphology at time 0 and after 6 hours of perfusion. Additionally, the perfused spleens cleared S. pneumoniae strains to below-detection levels. Conclusion Our work demonstrates that a stable human splenic ex-vivoperfusion model which maintains structural and physiological integrity can be achieved from tissue that would otherwise be discarded. The continued physiological function is confirmed by the clearance of S. pneumoniae. While currently employed for microbiological studies, this model has the potential to facilitate a wide range of different translational science studieswhile reducing the need for animal experimentation. The perfusion times employed for the present study were sufficient to demonstrate bacterial clearance which was the aim but there is capacity in the system to significantly prolong the duration.

The Correlation of Bile Duct Dilatation in Postmortem Computed Tomography of Lethal Intoxication Cases for Different Drug Types-A Retrospective Study.

To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups (e.g., stimulants, hypnotics, antipsychotics, etc.). We retrospectively measured the CBD using PMCT in cases with lethal intoxication (n = 125) and as a control group in cases with a negative toxicological analysis (n = 88). Intoxicating substances were classified into the subgroups (opiates, opioids, stimulants, hypnotics, antipsychotics, gasses, and others). Significance between the study and control groups was tested with the Mann-Whitney U test, and correlations were examined by using crosstables. There was a statistically significant difference between the CBD diameters in the intoxication group overall, when compared to the CBD diameter in the control group (p < 0.001). For both subgroups of "opiates" and "opioids", there was a strong statistically significant difference between the CBD diameter (being wider) in those groups compared to the control group (both p = 0.001). For the three subgroups "hypnotics", "stimulants", and "psychotropic drugs", there was no statistically significant difference between the CBD diameters in the intoxication subgroups when compared with the control group. The other subgroups were too small for statistical analysis. A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.

A Spectrum of Neural Tube Defects: An Observational Study in the Eastern State of India

Objective: This study aimed to determine the prevalence and types of neural tube defects (NTDs) in eastern India, examine the associated maternal and paternal risk factors, and evaluate the impact of antenatal ultrasonography for early detection and management.Materials and Methods: A four-year observational study was conducted at the IMS and SUM Hospital, SOA University, Bhubaneswar, India, from July 2020 to June 2024. Pregnant women attending the antenatal clinic were screened for NTDs by using high-resolution ultrasonography. Diagnosed cases were further confirmed by postmortem autopsy, when available. Relevant maternal and paternal demographic data, including age, socioeconomic status, consanguinity, body mass index (BMI), hyperthermia, and paternal occupation, were collected. Statistical analysis was performed using Fisher’s exact test to identify significant associations between these factors and NTD occurrence, with significance set at P &lt; 0.05.Results: The incidence of NTDs was 9.12 per 1000 deliveries, with spina bifida (43.4%) being the most prevalent, followed by anencephaly (32.9%), and encephalocele (11.1%). NTDs were significantly associated with maternal age (20-24 years), lower socioeconomic status, consanguinity (12.93% of cases), maternal obesity (BMI ≥30 kg/m²), and hyperthermia (≥100 °F). Fathers engaged in labor-intensive occupations had higher rates of offspring with NTDs (56%). This study highlights the effectiveness of antenatal ultrasonography for early detection and management, particularly in high-risk populations.Conclusion: NTDs continue to pose a significant public health challenge in Eastern India. This study underscores the need for improved prenatal care, genetic counseling, and targeted public health interventions, including folic acid supplementation and lifestyle modifications, to mitigate risk factors. Future research should focus on expanding geographic coverage and integrating genetic analysis to better understand the complex interplay between environmental and genetic factors contributing to NTDs.

Complete atrioventricular septal defect with double orifice mitral valve in a calf with congestive heart failure

AbstractA 3–4‐week‐old, suckler, bull calf from Durham County, United Kingdom died due to congestive heart failure. Postmortem examination identified a Type C complete atrioventricular septal defect with concurrent double orifice mitral valve as the cause of the heart failure. Both atrioventricular septal defects and double orifice mitral valves have only rarely been reported in cattle, and never concurrently, to the authors’ knowledge.